Yang Yun-Liang, Ho Yong-An, Cheng Hsiao-Hsu, Ho Monto, Lo Hsiu-Jung
Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, Republic of China.
Infect Control Hosp Epidemiol. 2004 Jan;25(1):60-4. doi: 10.1086/502294.
To determine the susceptibilities of Candida species isolated from Taiwan to amphotericin B and fluconazole.
Prospective surveillance study.
Each hospital was asked to submit up to 10 C. albicans and 40 non-albicans Candida species during the collection period, from April 15 to June 15, 1999. One isolate was accepted from each episode of infection. The broth microdilution method was used to determine susceptibilities to amphotericin B and fluconazole.
Only 3 of 632 isolates, one each of C. famata, C. krusei, and C. tropicalis, were resistant to amphotericin B. A total of 53 (8.4%) of 632 clinical yeast isolates, consisting of 4% C. albicans, 8% C. glabrata, 15% C. tropicalis, and 70% C. krusei, were resistant to fluconazole. In contrast, no C. parapsilosis isolate was resistant to fluconazole. Isolates from tertiary-care medical centers had higher rates of resistance to fluconazole than did those from regional and local hospitals (11.4% vs 6.6%). Isolates from different sources showed different levels of susceptibility to fluconazole. All of the isolates with the exception of C. tropicalis and C. krusei isolated from blood were susceptible to fluconazole. A pattern of co-resistance to both amphotericin B and fluconazole was observed.
Non-albicans Candida species had higher rates of resistance to fluconazole than did C. albicans (44 of 395 [11.2%] vs 9 of 237 [3.8%]; P = .002). The increasing rate of fluconazole resistance in C. tropicalis (15%) is important because C. tropicalis is one of the most commonly isolated non-albicans Candida species.
确定从台湾分离出的念珠菌属对两性霉素B和氟康唑的敏感性。
前瞻性监测研究。
要求每家医院在1999年4月15日至6月15日的收集期内提交最多10株白色念珠菌和40株非白色念珠菌。每次感染事件仅接受1株分离株。采用肉汤微量稀释法测定对两性霉素B和氟康唑的敏感性。
632株分离株中只有3株对两性霉素B耐药，分别为法塔念珠菌、克鲁斯念珠菌和热带念珠菌各1株。632株临床酵母分离株中共有53株（8.4%）对氟康唑耐药，其中白色念珠菌占4%，光滑念珠菌占8%，热带念珠菌占15%，克鲁斯念珠菌占70%。相比之下，近平滑念珠菌分离株无对氟康唑耐药的情况。来自三级医疗中心的分离株对氟康唑的耐药率高于地区和当地医院（11.4%对6.6%）。不同来源的分离株对氟康唑的敏感性水平不同。除从血液中分离出的热带念珠菌和克鲁斯念珠菌外，所有分离株对氟康唑均敏感。观察到对两性霉素B和氟康唑的共同耐药模式。
非白色念珠菌属对氟康唑的耐药率高于白色念珠菌（395株中的44株[11.2%]对237株中的9株[3.8%]；P = 0.002）。热带念珠菌对氟康唑耐药率的上升（15%）很重要，因为热带念珠菌是最常分离出的非白色念珠菌属之一。
